RESUMO
On careful analysis of the clinical history of Case IV, we find that the patient from childhood has been having frequent fevers and joints pains and that during the present illness which has lasted for one year previous to admission, aside from the symptoms of cardiac failure and those referable to the lungs due to pulmonary tuberculosis, he had pain and swelling of the joints and also fever. Such clinical history is certainly very suggestive of rheumatic infection. Blood Wassermann was negative, and the autopsy findings including the histological examination of the viscera showed no evidence of syphilitic infection. The absence of Aschoff bodies is not against rheumatic infection inasmuch as they are not always found in the organs affected by rheumatic infeciton and they are especially absent in the chronic stage of the disease. The role played by rheumatic infection in the production of lesion in the aorta and in other arteries is very well recognizedAccording to M.A. Clerc and Noel Daschamps certain infections such as malaria, scarlet fever, typhoid, pneumonia, la grippe, and above all, acute articular rheumatism especially in children are mentioned as causative factors of aneurysm of the arch of the aortaV.P. Sydenstricker speaks of arteritis as one of the complications of rheumatic infection, although he says that arteritis is seldom recognized clinically but it may be suspected when there is tenderness on pressure over superficial arteritis. Aortic lesion due to rheumatic arteritis has been observedMalcolm Goodridge, discussing the diagnosis of syphilitic aortitis, in the Textbook of Medicine by Cecil, 4th edition, 1937, p. 1146, says: the age incidence of syphilitic diseases of the aorta is somewhat helpful in differentiating it from artheroma of the aorta, which is prone to occur in the declining years of life and from rheumatic aortitis which occurs in adolescence or early adult life. (Conclusion)